How Online Sports Betting Is Fueling a New Wave of Addiction

On her first day of Intro to Psychology in 2012, Mia* struck up a conversation with a fellow freshman named Jack. The two formed a friendship and then a relationship. Eventually, they got married.

Jack was always passionate about sports, and he enjoyed gambling too. He purchased lottery tickets, engaged in online betting, and joined multiple March Madness pools and fantasy football leagues. It was a seemingly harmless hobby.

The first sign that Jack’s gambling might be something more concerning came in 2018. Mia was a special education teacher and graduate student, and Jack worked in sociology. He handled the couple’s finances. Their jobs weren’t especially lucrative, but it seemed to Mia that they struggled more than they should have.

Then, a winning bet gave Jack a big payout. But instead of directing the windfall toward living expenses, he used it for more gambling. “That was my first little red flag,” Mia says.

Over the next few years, more warnings appeared. Jack asked family members for money. He was fired from a job that he loved when the miles he drove in the company car and billed for didn’t match his reports. Despite some significant gambling wins, debt collectors began calling. Outstanding payments piled up in the mail. At one point, the electricity was shut off. Mia was baffled.

Then, in 2022, she read the voicemail transcript of a missed call: A police detective wanted to talk to her. That couldn’t be right, she thought—it must be a scam. But she Googled the detective, and he was real. He told her that illegal acts had occurred, and he wanted to see if she was involved. “Everything came crashing down that day,” Mia says.

Jack was addicted to gambling, the couple was deeply in debt, and he may have committed crimes to obtain funds. When Mia’s friend walked into her classroom, Mia told her to get a trash can; she felt as if she were going to be sick.

She called her twin brother—a police officer—who calmed her down as she drove home in a daze. “It just felt as though I were in a movie,” Mia says. “I was shocked. I knew something was off, but I couldn’t figure it out—and I never expected it to be that big.”

Mia recalls how Jack described his addiction: “I was stuck in this cycle and couldn’t get out. I kept thinking that if I won, I would fix it all.”

That cycle led to six felony charges.

Jack is one of millions of online sports bettors—engaged in an activity that has exploded in popularity in the U.S. since the Supreme Court struck down a national ban against it in 2018. From which team will win the Super Bowl’s opening coin flip to the odds of Aaron Judge hitting a home run tonight, people are placing bets all day, every day.

For many, opening apps like DraftKings or FanDuel offers some harmless entertainment. But for individuals like Jack, it poses a risk arguably greater than gambling ever has.

Today, 38 states, as well as the District of Columbia and Puerto Rico, have legalized sports betting, igniting a legal gambling boom with bets on wins, bets on player performance, bets on Gatorade color—bets on almost anything. The dollar value of sports gambling rose from under $5 billion in 2017 to over $120 billion in 2023, according to American Gaming Association data—and 94 percent of those bets were placed online.

Online betting goes beyond sports: Prediction markets like Polymarket enable users to bet on all kinds of future events, from when a hurricane will make landfall, to the likelihood of a recession, to the next U.S. president.

Gambling has a long history in America, primarily illegal, although previous waves of legalization brought lotteries, casinos, and slot machines into the mainstream. But the new trend line is different, says University of Massachusetts Amherst professor of epidemiology Rachel Volberg: “This isn’t my first rodeo. But this one is surprising in how fast gambling is expanding.”

The Only Officially Addictive Behavior

Gambling is the only behavior—as opposed to substance—classified as an addiction in psychiatry’s diagnostic guide, the DSM-5. (The ICD-11, used by most countries outside of the U.S., also classifies gambling addiction as a disorder.) While the DSM-5 includes several chemical addictions, such as to drugs and alcohol, researchers generally don’t find that most compulsive behaviors like shopping, sex, or social media use qualify as addiction disorders.

When does gambling shift from pastime to addiction? A clinical diagnosis is made when an individual bets persistently despite significant distress and exhibits at least four criteria from among these nine: needing to bet larger quantities due to growing tolerance, irritability when abstaining from gambling, an inability to control or cut back, preoccupation with gambling, using it to cope with distress, chasing one’s losses, lying about gambling, turning to others to help with finances, and jeopardizing or losing a relationship, job, or other meaningful opportunity.

These hallmarks—tolerance, withdrawal, preoccupation, loss of control—are classic indicators of addictions. Lia Nower, Director of the Center for Gambling Studies at Rutgers University, recalls that a psychiatrist once quipped that there’s really only one question you need to know to assess addiction: Did gambling ever cause a problem in your life and did you quit afterward?

Those problems can be dire. For example, the sports news site Defector reported on a man who, after exhausting all other options for cash, began stealing from the bank accounts he had created for his young children with money from their baptism gifts and birthday celebrations.

When the brain becomes addicted to gambling, the system that controls rewards essentially goes into overdrive. That system is primarily run by the ventral striatum and the prefrontal cortex. In the beginning, small wins trigger small hits of dopamine, but over time, the craving for the next hit intensifies, requiring more or bigger bets to achieve the same “high,” demanding that the process continue, and diminishing the brain’s capacity to say no.

Betting also taps into the power of intermittent rewards. Robust research shows that intermittent rewards can lead to addiction because uncertainty keeps people hooked on the promise of another hit of dopamine. As the addicted brain chases bursts of euphoria, says psychiatrist Lantie Jorandby, “the reward centers get hijacked.”

Foundational research on gambling disorder by psychiatrist Marc Potenza of the Yale School of Medicine and others opens a fascinating window into the addicted brain. In an fMRI study of pathological gamblers, gambling cues triggered changes in the frontal, paralimbic, and limbic areas of the brain, which govern emotions and decision-making.

When anticipating a monetary reward, people with gambling disorder, just like those addicted to substance use, show blunted activity in the reward center called the ventral striatum. This is consistent with the “reward deficiency hypothesis,” which proposes that wins don’t produce the same spikes of dopamine as they do for non-addicted people, which can lead addicted gamblers to bet more and more.

Why Online Sports Betting Is Different

Sports betting today is an entirely new ballgame—and poses a higher risk of addiction—than past forms of gambling. This is due to technological, social, psychological, and economic factors.

First, it’s always available on your phone, just a tap away—and you can place bets with fresh odds on different outcomes at any point during any contest. You can’t get rid of your phone the way you can walk out of a casino, avoid the liquor store, or flush your pills down the toilet. You can delete the apps, but if you’re any kind of sports fan, you’ll still be bombarded with betting ads, promotions, and updates of live odds during televised games (and almost every game is televised or streamed somewhere today).

Plus, betting is fun. Putting a few bucks on a game can make you more invested in it—and more excited. In placing some bets to research this story, baseball—my absolute least favorite sport to watch—became a little more interesting because if the Dodgers were to score against the Astros in the seventh inning, my $5 would become $15! (It didn’t.)

Online sports betting has become a part of many people’s social lives, especially young men’s. A group of friends may place bets together at a soccer game or while watching Sunday football from the couch; the group chat could blow up with screenshots of locked-in bets and updates on wins, losses, and sportsbook account totals.

For others, however, betting is a carefully guarded secret. Someone can gamble away their life savings without anyone else realizing they have a problem. They don’t show up to work hungover. They don’t pass out in front of their kids. They just tap inconspicuously on their screen.

“What’s surprised me is how hidden it is,” says Shane Kraus, a psychologist and addiction researcher at the University of Nevada, Las Vegas. “People liquidate their 401K, their kid’s college account. People do things that aren’t always easily exposed.”

Online bets themselves are also riskier today. Folks can place bets all game long and immediately respond as the odds change. “This shortens the lag between bet and reward, increasing the speed and frequency of gambling, which increases the risk of problematic behavior,” reports a review by the National Council on Problem Gambling.

Many bets aren’t on singular outcomes, like which team will win or lose; they’re parlays—rosters of specific results that must all occur (but likely won’t) to achieve a big, lottery-style jackpot. Parlays, which massively favor the house, have been crucial to the rise in sports betting—and the rise in money lost. “It’s a far riskier product now,” Volberg says.

The sportsbooks are hard to avoid—and they’re incentivized to keep people hooked. It’s rare to find a game broadcast that’s not sponsored by DraftKings or FanDuel or plastered with reminders from ESPN Bet, with halftime coverage of the latest odds and a chyron of minute-by-minute updates.

When the legalized betting boom began, gambling apps showered new users with free-money promotions. The offers today aren’t as generous, but they’re still hard to pass up. I was greeted with, “Get a $1,000 deposit bonus!” when I downloaded DraftKings, and offers like, “Bet $5 and Get $150 in Bonus Bets INSTANTLY!” once inside the app.

Companies track customer data and send individualized incentives to users to encourage them to return to the field. They may also assign personal hosts to high-rollers, called VIPs, and ply them with credits and gifts. “The industry these days is a digital-first business. Companies use all the information, data, and insights they have on people to boost their profits,” says Heather Wardle, Professor of Gambling Research and Policy at the University of Glasgow. “That’s a fundamental shift.”

The combination of these forces can be powerfully addictive—even for people who don’t think they’re at risk. In 2024, the Wall Street Journal profiled a 41-year-old psychiatrist and mother of two who knew how the brain worked, and how betting was destroying her impulse-regulation, but couldn’t stop. And she tried—she told DraftKings she was addicted and needed help, and she tried to ban herself from gambling apps through the Pennsylvania Gaming Control Board. But she was reeled back in with VIP bonuses, eventually losing more than $400,000. She says that she became a “mystery” to herself.

A Surge in Gambling Disorder

Since legalization, searches for help with gambling addiction have jumped 23 percent nationally, according to a 2025 study in JAMA Internal Medicine. In some states with legal sports betting, like Massachusetts, Pennsylvania, and Ohio, the jump approached or surpassed 50 percent. “The rate of gambling problems among sports bettors is at least twice as high as among gamblers in general,” according to a 2019 report from the National Council on Problem Gambling.

To assess the prevalence of gambling disorder, researchers recently conducted a systematic review and meta-analysis, screening over 3,600 reports across 68 countries, and concluding that 46 percent of adults and 18 percent of adolescents had gambled in the past 12 months. The prevalence of problematic gambling was 1.4 percent.

That number may seem fairly low. But then half the population never gambles at all—so the percentage of problematic gambling among those who do gamble is actually much higher, Wardle explains. If you start, the risk isn’t small.

Anecdotal data support this finding. Therapists are seeing individuals whose lives have imploded due to sports betting. Lawyers are seeing folks for whom gambling has led to divorces and custody battles. “It just blew up,” says Jorandby, who practices at an addiction treatment center in Florida.

Demographically, young men represent the biggest cohort of sports bettors and the group most at risk. Young men are tech-savvy, less risk-averse, more impulsive, and more likely to watch sports. They can also be overconfident and more likely to believe that their passionate following of teams, players, and statistics will help them come out on top in what they perceive as a game of skill.

How to Treat Gambling Disorder

Treatment for gambling disorder involves approaching an individual’s addiction holistically. The first step is addressing financial and legal matters; often, a family member takes control of the individual’s finances. Therapy is central to treatment, typically cognitive behavioral therapy, in which the individual may learn about their addiction, explore their underlying motivation, create a contingency plan, develop coping skills, and work to change their behaviors.

The 12-step program offered by Gamblers Anonymous can be extraordinarily helpful for some through the community and structure it provides. (To accommodate the young men so prevalent in the new wave of disordered bettors, Gamblers Anonymous is developing Young Members Meetings.) Medication may also play a role; some evidence shows that Naltrexone, a medication approved for alcohol and opioid use addiction, can also curb gambling urges.

“There’s a very large co-occurrence of substance-based addictions and depression or anxiety with gambling, as people go down the rabbit hole of losing more money and getting more anxious,” Nower says. A 2021 study found that nearly a quarter of patients with gambling disorder were also diagnosed with a substance use disorder. Other studies have found even higher estimates.

Specific strategies can help curb, change, or eliminate online betting behavior. On the tech side, individuals can delete gambling apps, block websites, use filters to screen gambling ads, or install apps such as Gamban to help quit. On the social side, they may learn healthier ways to respond when a friend asks if they want to bet or when everyone else is betting while watching a game together. On the relationship side, the individual may work to repair broken ties. Betrayal is common in these circumstances, as someone may have lied to, stolen from, or financially ruined a family member.

But perhaps the central question in treating gambling disorder is: Why? Why is the person gambling, and what does it provide them? Maybe a young man is struggling with depression, and betting gives him a jolt of energy. Maybe an athlete faces intense pressure to perform and uses sports betting to unwind. Maybe a marriage is deteriorating, and betting provides an escape.

Identifying that core motivation can help individuals understand their behavior and address the discomfort at its root—but it’s difficult work. It’s hard to sit in discomfort with no distractions or escape while in the throes of addiction. “Addiction doesn’t allow you to think objectively. All it wants you to do is gamble,” Kraus says. He teaches people mindfulness and emotion regulation skills to tolerate discomfort so they can create space between the urge to gamble and the act of gambling. “We teach people that an urge is a thought, a feeling, but just that. You don’t have to gamble. You can have thoughts that don’t have power,” he says.

As with any addiction, relapse is often part of the recovery process, but with treatment that encompasses community, identity, health, and more, recovery is possible. Nower once treated an older man who spent every dime he had on lottery tickets. He had previously loved spending time with his family and grandchildren, but shame around his gambling problem led him to withdraw. Nower treated him with cognitive behavioral therapy and behavior modification. They worked on resisting the lottery and rebuilding his identity outside of it; he eventually substituted for gambling with coaching his grandson in Little League.

One surprising hurdle to treatment is a lack of awareness among clinicians of the signs of gambling disorder or the extent of the damage it can cause. “Most clinicians aren’t trained, despite the explosion of legalized gambling,” Nower says. Education to help professionals recognize and treat gambling disorder, as well as screening in different settings—legal, medical, psychological—could change that.

The challenge is exacerbated by the fact that gambling addiction is often cloaked in secrecy and shame. “Most people with gambling disorder do not seek treatment,” Potenza says. They may come to therapy for other reasons—stress, depression, divorce—and their gambling problem emerges along the way. Therapists broaching the topic by asking open-ended, nonjudgmental questions—rather than asking about addiction directly—can help clients open up about their struggles.

Policy Solutions

Treatment for gambling disorder typically focuses on personal choices and actions—blocking ads, resisting apps, engaging in therapy. But should it all fall to the individual? Broader policy decisions about sports betting need to be considered as well.

Regulation is always a trade-off between public health and individual liberties. Gambling provides fun and excitement to many people (as well as significant tax revenue to states). It’s a difficult balance, but policies can maintain freedoms while protecting vulnerable people from worst-case outcomes. It begins with understanding that the vast majority of losses are shouldered by a small sliver of the population. A 2024 study of 700,000 online sports bettors found that just 3 percent of them generated more than 50 percent of sportsbooks’ revenue. Those are the individuals who most need protection.

Various states and countries have established legal limits on sportsbook advertising, targeting, data collection, and betting amounts. For example, Germany imposes a monthly deposit limit of 1,000 euros in bettors’ accounts; that’s the maximum one can lose each month. The Netherlands prohibits companies from using personal information to target people for promotions. Italy bars gambling companies from being primary sponsors of sports teams.

Policies in the U.S. haven’t gone nearly as far. Some states now track addiction rates, provide free treatment, or allow gambling disorder to be reimbursed by Medicaid, but many others take no such actions. This may be because the legalized gambling market in the U.S. market is newer than in Europe, and the harms haven’t yet been felt as fully. “If we don’t do anything now, we’re going to be swimming in it in three or four years. It’s like opioids. That didn’t magically happen—it’s a slow process. We knew we had an issue and didn’t turn the ship right away,” Kraus says. “As a researcher, I’m shocked. We could be trying to figure it out quickly, and we’re not.”

Breaking the Cycle

That call Mia received from the detective shattered her reality. From September to February, she didn’t hear anything from the police but every day, she wondered when the other shoe would drop. And then it did: formal charges, hearings, and a sentence of nine months in jail. Jack’s six felony charges included identity theft, as he had used client information from his company to obtain gambling money.

Mia took over the family finances. They each began individual therapy. Jack developed a relapse prevention plan, explored his triggers, and processed some of the pain in his past, including his father’s addictions to alcohol and substance use. At Mia’s mother’s suggestion, he joined Gamblers Anonymous, and Mia, Gam-Anon. “That’s the thing that’s gotten me through, honestly,” Mia says. She finds it to be a community of people who truly understand her experience.

Mia gradually came to terms with what happened in their relationship. The couple is still rebuilding the trust that was broken. But the thing that kept her committed to their life together is this: “I knew it wasn’t truly him.”

Two days before Jack was due to go to jail, his nine-month sentence was converted to electronic monitoring from home. This past summer, his electronic monitoring bracelet came off. The two celebrated their sixth wedding anniversary by spending time with friends and ordering Mexican food for a cozy night at home.

The journey is far from over. But replacing the secrecy of addiction with openness, honesty, and treatment has instilled hope for the future. “We made it through the scariest part. I feel gratitude for that,” Mia says. Her community has allowed her to open up and begin healing. “It’s important for people to share their stories. You never know whom it’s going to help,” she says. “I know there are more people out there.”

*Names have been changed to protect privacy.

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